Medical device for overcoming airway obstruction

ABSTRACT

A medical device used to overcome upper airway obstruction when a patient is placed in a supine position that includes a cradle having first and second plates. A band that attaches to the second plate, wherein the first plate has a length that allows a patient&#39;s head to rest on and the second plate is perpendicular to the first plate and has a length at least a distance that allows a band to be placed under a patient&#39;s chin and encircle the second plate so that an upward pull can be generated on the chin by the band. The second plate&#39;s width is at least a distance that allows for the clearance of a patient&#39;s side facial features when the patient&#39;s head rests on the first plate and the band encircles the chin of a patient and attaches to the second plate and the second plate has a middle attachment means located at the outer extremity of the second plate and the middle attachment means is centered and runs parallel to the width of the second plate. The ratio of the length of the plates is at least 1 to 1.

CROSS REFERENCES

The present application is a divisional of my application Ser. No.10/610,399 filed Jun. 30, 2003, entitled “Medical Device for OvercomingAirway Obstruction.

BACKGROUND

Airway obstruction complications can arise when a patient is lying inthe supine position while unconscious in an operating room or at anyother emergency site. For example, when an unconscious person is restingin the supine position, the person either being sedated or anesthetized,gravity will pull the person's tongue downwards (towards the cervicalspine) and the tongue will obstruct the airway and impede respiration,partially or completely. The above example might cause alife-threatening situation if the airway obstruction is not cleared, forhypoxemia and death can quickly ensue.

Anesthesiologists commonly overcome airway obstruction by tilting thepatient's head backwards and pulling the chin up and away from the body(cephalad). Obstruction is avoided because the base of the tongue isattached to the mandible, and by pulling the chin up the tongue will besimultaneously pulled upward. This practice is very fatiguing andrestricts the anesthesiologist's ability to perform other functions thatrequire two hands.

An upper airway can also be maintained open by inserting various medicaltubes into the body, for example, nasal-pharyngeal, oral-pharyngeal, endtracheal, laryngeal mask airway (LMA) and the cuffed oral pharyngeal. Asof today, there are no medical devices in common use that attachexternally to the face that will maintain an open upper airway.

In the past, practitioners have used surgical tape to attempt tomaintain an open upper airway. Practitioners would secure tape aroundthe chin of a patient and then attach the ends of the tape to anoperating table. Tape procedures are unsatisfactory; for the tapeattachment does not provide the upward pull required on the chin tomaintain an open upper airway. Other complications with this proceduremight be as follows: eye damage (this might occur when the tape securingthe patient's chin graces the eye of the patient, gracing might occur ifpatient coughs or moves his head and skin trauma.

Chin props comprising a ball on the end of an arm secured to theoperating room table have also been used to push the chin up. They toohave proven unsatisfactory and are not commonly used. The reason thatthis type of chin prop is unsatisfactory is that they are large andcumbersome and get in the way of surgeons operating on the upper body.Furthermore, if misapplied they may constrict the airway. Chin props aredesigned to function with suitable operating tables that have complexmechanisms. Therefore, some chin props are not suitable for the use ataccident sites or in ambulances transporting the injured.

Information relevant to attempts to address these problems can be foundin U.S. Pat. Nos. 5,494,048, 6,200,285 B1, and 6,196,224 B1. However,each one of these references suffers from one or more of the followingdisadvantages:

-   -   1. Can cause eye damage;    -   2. Require suitable operating tables;    -   3. Obstruct the view of the patient;    -   4. Do not provide sufficient upward leverage to the chin;    -   5. Do not lend themselves to use in accident situations;    -   6. Do not prevent airway obstruction; and    -   7. Difficulties in removal of devices, should complications        arise.

Inside and outside the operating room, a need exists for equipment thatmaintains an open airway. This equipment should be compatible andimprove the effectiveness of oral-pharyngeal and nasal-pharyngealairways and face masks. In the operating room, such equipment mightreduce the need for the use of expensive endotracheal tubes in generalanesthesia and allow mask anesthesia to be used for sedated patients.Outside the operating room, a need exists for compact equipment thatwill maintain an open airway and that can be used in cramped quarterssuch as an ambulance, hyperbaric chamber and an MRI chamber.

For the foregoing reasons, there is a need for a medical device thatwill maintain an open airway in the anesthetized and sedated patientlying in a supine position in an operating room and any unconsciouspatient lying in the supine position at any site. To be effective, theequipment should be safe and easy to use, and the procedure for its useshould be simple and reliable. The equipment should free up theoperators' hands; render oral and nasal pharyngeal airways moreeffective and not interfere with but facilitate the use of a mask. Theequipment should be free standing and portable.

SUMMARY

The present invention is directed to a medical device that assists inovercoming airway obstruction when a patient, that may or may not beanesthetized, is unconscious and placed in the supine position. Thisdevice satisfies the following needs:

-   -   1. It frees the practitioner's hands to do other tasks while        providing anesthesia to a patient;    -   2. It allows the practitioner to monitor the patient while the        patient is anesthetized;    -   3. It is a compact and mobile device;    -   4. It does not cause eye damage to an anesthetized patient;    -   5. It provides the maximum flow of air to an anesthetized        patient with out the use of the practitioner's hands;    -   6. Does not require the use of specific tables when operating        the device; and    -   7. Allows for the easy removal of the device should an emergency        situation arise.

The medical device for overcoming airway obstruction has an “L” shaped(in profile), rectangular cradle with first and second plate, whereinthe first plate has a length at least a distance to allow a patient'shead to rest on and act as an anchor to the cradle. The second plate hasa length that is at least a distance to allow a band to be placed undera patient's chin and encircle the second plate. In this manner, anupward pull can be generated on the chin by the band when the secondplate is placed in a perpendicular position to the first plate. Thewidth of the cradle is at least a distance that allows for the clearanceof a patient's side facial features when the patient's head rests on thefirst plate of the cradle and a band is made to encircle the chin of apatient and attach to the second plate of the cradle; and a band thatattaches to the second plate of the cradle when the second plate isperpendicular to the first plate.

One of the many advantages of this invention is the simplicity of itsconstruction. The two main elements of this invention are perpendicularplates and a band that easily attaches to one of the plates of thecradle after encircling the chin of a patient whose head rests on theother plate of the cradle after being placed in a supine position. Thelack of numerous additional elements attests to the simplicity ofconstruction and use of this device. Eye damage and irritation, injuriesthat have been previously caused by the prior art, are minimized by thepresently claimed invention. This invention also aids those in theemergency transportation field, for they need to have the maximum use oftheir hands when dealing with unexpected emergency situations. Forexample, not having to worry whether the patient is getting sufficientairflow allows emergency personnel to care for other injuries sustainedby the patient during the transport of the patient.

A further advantage to this invention is that it is a stand-alonemedical device. The device does not need to be attached to anysupporting devices to become operable. When a patient's head is made torest on one of the sides of the perpendicular plates, the weight of thepatient's head on the cradle is sufficient to secure the cradle on mostsurfaces so that an upward pull on the chin created between a bandattached to the side of the cradle not carrying the weight of thepatient's head and the patient's chin will be maintained during the useof this device. Remember, so long as this upward pull is maintained, theupper airway will be maintained open. Hence, it is key that the tensioncreated with this device is not compromised and this is easily solvedusing the weight of the patients head as the anchor to the device.

Yet another advantage to this invention is that the placement of theband on the second plate insures that the band does not come in contactwith the patient's eyes, this is very important for one cannot controlwhen an unconscious person has an involuntary contraction or movement.

DRAWINGS

These and other features, aspects, and advantages of the presentinvention will become better understood with regard to the followingdescription, appended claims, and drawings where:

FIG. 1 shows a perspective view of the medical device in use with apatient in a supine position;

FIG. 2 shows a perspective view of another version of the medical devicein use with a patient in a supine position;

FIG. 3 shows a rear view of the medical device shown in FIG. 2, thisview shows the second cradle having an aperture within the secondcradle;

FIG. 4 shows a perspective view of another version of the presentinvention, this embodiment has a means for pivoting the cradles and alocking means for maintaining the cradles in a perpendicular position;and

FIG. 5 shows a perspective of how the mask would attach to the firststrap of the medical device and surround the nose and mouth of a patientin a supine position.

DESCRIPTION

As shown in FIG. 1, a medical device used to overcome upper airwayobstruction when a patient is in a supine position comprises a flatrectangular cradle 10 that has a first 12 and a second plate 14 whereinthe first plate 12 has a length that is at least a distance that allowsa patient's head to rest on and act as an anchor to the cradle and thesecond plate 14 is perpendicular to the first plate 12 and has a lengththat is at least a distance that allows a band 16 to be placed under apatient's chin and encircle the second plate 14 so that an upward pullcan be generated on the chin by the band 16, and the cradle's width isat least a distance that allows for the clearance of a patient's sidefacial features when the patient's head rests on the first plate 12 ofthe cradle 10 and a band 16 is made to encircle the chin of a patientand attach to the second plate 14 of the cradle; and a band 16 thatattaches to the second plate of the cradle when the second plate 14 isperpendicular to the first plate 12.

The cradle can be made of stainless steel, plastics or polymers. Thelength of first 12 and second 14 portions of the cradle must be at leasta 1 to 1 ratio. The length of the first plate 12 should be at least of alength that will allow a patients head to rest on it and act as ananchor to the medical device. The length of the second plate 14 shouldbe of at least of a length that will create an upward pull on the chinof a patient when a band 16 is made to encircle the chin of the patient,when a patient is placed in a supine position, and the second plate 14of the cradle 10. In a preferred embodiment of the invention, the lengthof the cradles will be eight inches to twelve inches. Another embodimentof the invention has the first 12 and second 14 plates of the cradlesbeing both eight inches in length. The width of the cradles is to be atleast eight-inches, the preferred embodiment would have a width oftwelve inches. The width has to be of sufficient length to allow for theclearance of the eyes when attaching the band 16 to the second plate 14of the cradle 10. As seen in FIG. 2 and FIG. 3, the second plate 14 ofthe cradle can define an aperture 14 a that will merely make the secondplate of the cradles a physical skeleton to attach the band 16 or strapsyet to be defined.

The band can be made of an elastic material that has a degree of tensionsufficient to pull the weight of a person's chin upward (when thepatient is placed in a supine position) when encircling the second plateof the cradle and the chin of the patient. As seen in FIG. 2, the band16 can also be made of fabric and have two ends, if the band 16 is madeof fabric, then it is preferable that the ends of the bands 16 a haveeither hook or pile fasteners. When using a fabric band 16, it isessential that the second plate 14 of the cradle have two receivingmeans 22 located on opposite sides of the second plate 14 and runningalong the length of the second plate 14 and situated a sufficient heightto allow for an upward pull to be generated on the chin of a patientwhen the band 16 is placed around the chin of the patient and the endsof the band 16 a are attached to receiving means 22 of the second plate14 of the cradle. The receiving means 22 will also comprise of eitherhook or pile fasteners, depending on what type fasteners the ends of theband 16 a utilize.

As seen in FIG. 2, the medical device can further comprise of having amiddle attachment means 18 attached second plate 14 of the cradle(middle attachment means 18 can simply be glued on to the second plate14), the middle attachment means 18 will attach to the second plate 14at the outer extremity of the second plate 14 b and be centered and runparallel along the width of the cradle 10. The attachment means 18 canbe made of a fabric and contain hook or pile fasteners. The middleattachment means 18 is attached to a first strap 20, the first strap 20has either hook or pile fasteners at its ends 20 a (whether hook or pilefastener will depend on what type of attachment means the ends areconnecting too). The first strap 20 will connect to the section (middlejuncture) of the band 16 b surrounding the chin of the patient usingmeans known in the art (either hook or pile fasteners, this all dependson what type of fasteners the band has at the middle juncture of theband 16 b to accommodate the connection). The first strap might define afirst strap slit 20 b running parallel along the length of the firststrap. The first strap serves a duel purpose, the first purpose is tofurther apply upward pressure to the chin and the second purpose is toallow for the placement of a mask 26 within the slit that would coverthe mouth and nose of the patient. The mask 26 would be used to provideeither oxygen and/or an anesthetic to the patient.

The medical device can further comprise a second strap 24, the secondstrap 24 having attachment means located at the ends of the strap 24 a(the attachment means would be either hook or pile fasteners). Thesecond strap would encircle the rear of the patient's neck and wouldattach to the middle juncture of the band 16 b fasteners. The onlypurpose for the second strap 24 is to secure the band 16 to thepatient's chin, the invention does not require the second strap 24; itis used only as a safety precaution.

As seen in FIG. 4, another embodiment of the invention would comprise ofa pivoting means 34 for folding the medical device. The pivoting means34 would facilitate the transport of the device and would most likely beused in the field by emergency personnel, such as paramedics. Thepivoting means 34 would connect the first 12 and second 14 plates of thecradles and have a closed locking position and an opening perpendicularlocking position 36. The locking means would be incorporated into thepivot by means known in the art. As a safety precaution, the pivotingmeans, when placed in the perpendicular position would be placed so thatthey would not be able to rotate further than the perpendicular. Thiscould simply be accomplished by inserting a screw along side thepivot(s) in either of the portions (allowing the head of the screw to beraised at least a few centimeters above the pivot) so that the portionnot containing the screw could not be pivoted beyond the perpendicular.All of the previous elements discussed could be incorporated into thisembodiment of the invention.

A method of overcoming upper airway obstruction when a patient is in asupine position comprises the steps of placing the above mentionedmedical device on a flat surface, resting the back of a patient's headon the first plate 12 of the cradle, and encircling the chin of thepatient with the band 16 and attaching the rest of the band to thesecond plate 14 of the cradle, the band's attachment to the second plate14 would be in a position sufficiently high so that an upper pull can begenerated on the chin of the patient.

The above method describes the most rudimentary use of the medicaldevice described in this application. The medical device's main purposeis to prevent the blockage of the upper airway. As stated before, thisis accomplished by pulling the chin up and away from the body. The band16 pulls the chin upward and the second plate 14 of the cradle is usedto ensure that the pressure applied to the chin is maintained whilefreeing the hands of the practitioner. The medical device can also beused as means to secure a mask 26 to the face of a patient.

An advantage of the present invention is that a patient's eyes are neverin danger of being damaged, for when the band is placed to encircle thechin of the patient and then attached to the second plate of the cradle,the band attaches to the second plate of the cradle at a position thatdoes not allow the band to rub against the eyes.

Another advantage of the present invention is that when using theembodiment that defines an aperture in the second plate of the cradle, apatient can be monitored from behind the patient, there is noobstruction when monitoring the breathing of the patient.

A further advantage of the present invention is that it is compact andrudimentary in its nature. The device can be made operational by simplyplacing the device on a flat surface, placing a patient's head on thedevice (the patient being in a supine position) and encircling anelastic band around the patient's chin and the second portion of thecradle.

Yet further a further advantage to the device is that it does notrequire other structures to become operational, it is the ideal devicefor practitioners working in the field, paramedics.

Another advantage of the invention is the simplicity in which it can betaken off a patient should an emergency situation arise, you simplywould pull the bands off the hook and pile fasteners.

A last advantage to this device is that it frees the hands of theoperator, thereby allowing the operator to help the patient with othercomplications that the patient might be experiencing.

Although the present invention has been described in considerable detailwith reference to certain preferred versions thereof, other versions arepossible. Therefore the spirit and the scope of the claims should not belimited to the description of the preferred versions contained herein.

1. A medical device used to overcome upper airway obstruction when a patient is placed in a supine position comprising: a cradle having first and second plate; and a band attached to the second plate, wherein the first plate has a length that allows a patient's head to rest on and the second plate is perpendicular to the first plate and has a length at least a distance that allows a band to be placed under a patient's chin and encircle the second plate so that an upward pull can be generated on the chin by the band, the second plate's width is at least a distance that allows for the clearance of a patient's side facial features when the patient's head rests on the first plate and the band encircles the chin of a patient and attach to the second plate and the second plate has a middle attachment means located at the outer extremity of the second plate and the middle attachment means is centered and runs parallel to the width of the second plate; and wherein the ratio of the length of the plates is at least 1 to
 1. 2. The medical device of claim 1, further comprising a first strap that attaches to the middle section of the band attached to the patient's chin, the middle section being the part of the band contacting the patient's chin, and the first strap further attaches to the middle attachment means.
 3. The medical device of claim 2, wherein the band has two ends, each end having an attachment means for attachment to the second plate and wherein the second plate has two receiving means for attachment to the ends of the band, the receiving means of attachment being located on opposite sides of the second plate and situated to allow for an upward pull on the patient's chin.
 4. The medical device of claim 3, further comprising a second strap having two ends, each end of the second strap having attachment means that would attach to the band after the second strap encircles the back of the neck of the patient.
 5. The medical device of claim 4, wherein the first strap defines a middle slit being centered and running along the length of the first strap.
 6. The medical device of claim 5, further comprising a mask that is placed within the middle slit.
 7. The medical device of claim 2, wherein the second plate defines an aperture sufficient in size to allow for the monitoring of the patient when the user of the device is standing behind the second plate of the cradle.
 8. The medical device of claim 7, wherein the second plate has a middle attachment means located at the outer extremity of the second plate and the middle attachment means is centered and runs parallel to the width of the second plate.
 9. The medical device of claim 8, wherein the band has two ends, each end having an attachment means for attachment to the second plate and wherein the second plate has two receiving means for attachment to the ends of the band, the receiving means of attachment located on opposite sides of the second plate and situated to allow for an upward pull on the patient's chin.
 10. The medical device of claim 9, further comprising a second strap having two ends, each end of the second strap having attachment means that would attach to the band after the second strap encircles the back of the neck of the patient.
 11. The medical device of claim 10, wherein the first strap defines a middle slit being centered and running along the length of the first strap.
 12. The medical device of claim 11, further comprising a mask that is placed within the middle slit.
 13. The medical device of claim 1, wherein the length of the cradle measures 20 inches and the plates are in a 2 to 3 ratio, and the width of the plates measure 8 inches.
 14. A medical device used to overcome upper airway obstruction when a patient is placed in a supine position comprising: a first plate having a length of at least 8 inches and a width of 8 inches; a second plate having a length of 8 inches and a width of 8 inches; a means for pivoting that attaches to the first and second plates alongside the width of the plates and allows the plates to fold on top of each other when pivoted in a first direction and when pivoted in a second direction the plates would rest perpendicular to each other; and a band that encircles and attaches to the second plate when the second plate is perpendicular to the first plate so that when the patient's head rests on the first plate the band encircles the chin of the patient.
 15. The medical device of claim 14, further comprising a locking means for locking the plates in a perpendicular position.
 16. The medical device of claim 15, wherein the second plate defines an aperture sufficient in size to allow for the monitoring of the patient when the user of the device is standing behind the second plate.
 17. The medical device of claim 16, wherein the second plate has a middle attachment means located at the outer extremity of the second plate and the middle attachment means is centered and runs parallel to the width of the second plate.
 18. The medical device of claim 17, further comprising a first strap that attaches to the middle section of the band attached to the patient's chin, the middle section being the part of the band contacting the patient's chin, and the first strap further attaches to the middle attachment means.
 19. The medical device of claim 18, wherein the band has two ends, each end having an attachment means for attachment to the second plate and wherein the second plate has two receiving means for attachment to the ends of the band, the receiving means of attachment being located on opposite sides of the second plate and being situated at a sufficient height to allow for an upward pull on the patient's chin.
 20. The medical device of claim 19, further comprising a second strap having two ends, each end of the second strap having attachment means that would attach to the band after the second strap encircles the back of the neck of the patient.
 21. The medical device of claim 20, wherein the first strap defines a middle slit being centered and running along the length of the first strap.
 22. The medical device of claim 21, further comprising a mask that is placed within the middle slit.
 23. A method of overcoming upper airway obstruction when a patient is placed in a supine position comprising placing a medical device on a flat surface, wherein the medical device is as follows: a cradle that has a first and a second plate; and a band that attaches to the second plate of the plate when the second plate is perpendicular to the first plate, wherein the first plate has a length that is at least a distance that allows a patient's head to rest on and the second plate is perpendicular to the first plate and has a length that allows a band to be placed under a patient's chin and encircle the second plate so that an upward pull can be generated on the chin by the band, and the plate's width is at least a distance that allows for the clearance of a patient's side facial features when the patient's head rests on the first plate and a band encircles the second plate and the chin of the patient; and wherein the second plate has a middle attachment means located at the outer extremity of the second plate and the middle attachment means is centered and runs parallel to the width of the second plate; resting the back of the head of the patient on the first plate so that the head of the patient anchors the cradle; and encircling the band at a certain height of the second plate and around the chin of the patient so that an upward pull is created on the chin when the band contacts the second plate. 